Osteoarthritis and the rule of halves

<b>Background</b> Symptomatic osteoarthritis poses a major challenge to primary health care but no studies have related accessing primary care ("detection"), receiving recommended treatments ("treatment"), and achieving adequate control ("control").<p></p> <b>Objective</b> To provide estimates of detection, treatment, and control within a single population adapting the approach used to determine a Rule of Halves for other long-term conditions.<p></p> <b>Setting</b> General population.<p></p> <b>Participants</b> 400 adults aged 50+ years with prevalent symptomatic knee osteoarthritis.<p></p> <b>Design</b> Prospective cohort with baseline questionnaire, clinical assessment, and plain radiographs, and questionnaire follow-up at 18 and 36 months and linkage to primary care medical records.<p></p> <b>Outcome measures</b> "Detection" was defined as at least one musculoskeletal knee-related GP consultation between baseline and 36 months. "Treatment" was self-reported use of at least one recommended treatment or physiotherapy/hospital specialist referral for their knee problem at all three measurement points. Pain was "controlled" if characteristic pain intensity <5 out of 10 on at least two occasions.<p></p> <b>Results</b> In 221 cases (55.3%; 95%CI: 50.4, 60.1) there was evidence that the current problem had been detected in general practice. Of those detected, 164 (74.2% (68.4, 80.0)) were receiving one or more of the recommended treatments at all three measurement points. Of those detected and treated, 45 (27.4% (20.5, 34.3)) had symptoms under control on at least two occasions. Using narrower definitions resulted in substantially lower estimates.<p></p> <b>Conclusion</b> Osteoarthritis care does not conform to a Rule of Halves. Symptom control is low among those accessing health care and receiving treatment

Two-proton correlations from 158 AGeV Pb+Pb central collisions

The two-proton correlation function at midrapidity from Pb+Pb central collisions at 158 AGeV has been measured by the NA49 experiment. The results are compared to model predictions from static thermal Gaussian proton source distributions and transport models RQMD and VENUS. An effective proton source size is determined by minimizing CHI-square/ndf between the correlation functions of the data and those calculated for the Gaussian sources, yielding 3.85 +-0.15(stat.) +0.60-0.25(syst.) fm. Both the RQMD and the VENUS model are consistent with the data within the error in the correlation peak region.Comment: RevTeX style, 6 pages, 4 figures, 1 table. More discussion are added about the structure on the tail of the correlation function. The systematic error is revised. To appear in Phys. Lett.

Event-by-event fluctuations of average transverse momentum in central Pb+Pb collisions at 158 GeV per nucleon

We present first data on event-by-event fluctuations in the average transverse momentum of charged particles produced in Pb+Pb collisions at the CERN SPS. This measurement provides previously unavailable information allowing sensitive tests of microscopic and thermodynamic collision models and to search for fluctuations expected to occur in the vicinity of the predicted QCD phase transition. We find that the observed variance of the event-by-event average transverse momentum is consistent with independent particle production modified by the known two-particle correlations due to quantum statistics and final state interactions and folded with the resolution of the NA49 apparatus. For two specific models of non-statistical fluctuations in transverse momentum limits are derived in terms of fluctuation amplitude. We show that a significant part of the parameter space for a model of isospin fluctuations predicted as a consequence of chiral symmetry restoration in a non-equilibrium scenario is excluded by our measurement.Comment: 6 pages, 2 figures, submitted to Phys. Lett.

NA49 Results on Single Particle and Correlation Measurements in Central Pb+Pb Collisions

Single-particle spectra and two-particle correlation functions measured by the NA49 collaboration in central Pb+Pb collisions at 158 GeV/nucleon are presented. These measurements are used to study the kinetic and chemical freeze-out conditions in heavy ion collisions. We conclude that large baryon stopping, high baryon density and strong transverse radial flow are achieved in central Pb+Pb collisions at the SPS.Single-particle spectra and two-particle correlation functions measured by the NA49 collaboration in central Pb+Pb collisions at 158 GeV/nucleon are presented. These measurements are used to study the kinetic and chemical freeze-out conditions in heavy ion collisions. We conclude that large baryon stopping, high baryon density and strong transverse radial flow are achieved in central Pb+Pb collisions at the SPS

Xi and Xi-bar Production in 158 GeV/Nucleon Pb+Pb Collisions

We report measurements of Xi and Xi-bar hyperon absolute yields as a function of rapidity in 158 GeV/c Pb+Pb collisions. At midrapidity, dN/dy = 2.29 +/- 0.12 for Xi, and 0.52 +/- 0.05 for Xi-bar, leading to the ratio of Xi-bar/Xi = 0.23 +/- 0.03. Inverse slope parameters fitted to the measured transverse mass spectra are of the order of 300 MeV near mid-rapidity. The estimated total yield of Xi particles in Pb+Pb central interactions amounts to 7.4 +/- 1.0 per collision. Comparison to Xi production in properly scaled p+p reactions at the same energy reveals a dramatic enhancement (about one order of magnitude) of Xi production in Pb+Pb central collisions over elementary hadron interactions.Comment: 15 page